David L. Joffe, BSPharm, CDE, FACA

(Editor-in-Chief Diabetes In Control) A graduate of University of Kentucky College of Pharmacy, he has practiced in the Tampa Bay area since 1986, has been providing diabetes and cardiovascular care in Tampa Bay since 1995, and spent 2 years as an Eckerd Patient Care Pharmacist managing over 100 diabetes patients. Dave currently sees patients in over 30 primary care and endocrinologists offices.

In issue 162, published in June 2004, we had an item from the BMJ touting a polypill that could reduce heart attack and strokes in 80% of all people over 55 who had some sort of vascular problem. This pill had 6 drugs, including: a cholesterol-lowering statin; three blood-pressure medications; folic acid; …

Three days ago I got a call from a patient who needed some insulin. The problem was, I had not seen the patient in 6 years — since I had first trained him on his insulin pump. Apparently they had gone out of town; he had prefilled cartridges with him and left them in a …

In this week's Homerun Slides, Dave Joffe, editor-in-chief of Diabetes in Control, presents strategies for helping type 2 patients to achieve their glycemic goals, starting with an outline of diabetes team members.

Last week in our Clinical Series we had an excerpt from International Textbook of Diabetes Mellitus, 4th Ed., looking at Beta-Cell response to nonglucose secretagogues. This text dealt with how the beta cells might be affected by more than just glucose. We are learning more about how fat. protein, and non-insulin peptides might have effects we had never …

Last week, I had a new patient referred to me with adult onset type 1 diabetes. The patient was 63 years old and — although she had been losing weight over the past year — it was a 16 pound loss over the previous 2 weeks that got the physician concerned. An A1c test came …

Sometimes, when we want to impress our patients with the importance of their disease, we will list all the possible effects of the disease. These include blindness, kidney failure, and amputations. But what do we tell our patients that have pre-diabetes or impaired glucose tolerance? This week, we have an …

For years the crux of diabetes care for type 2’s has been to reduce the amount of glucose going in and the amount of glucose being absorbed. We put patients on carbohydrate-restricted diets, have them take fiber before a meal, and use medicines such as acarbose. For the most part …

If you are still stuck on the “metformin to start with and max out the dose” diabetes treatment algorithm, then you’d better take a look at this week’s homerun slides. Considering there are 11 distinct pathways to developing diabetes, it doesn’t make any sense that all our patients would only have …

Last week the FDA announced that they were going to approve 6 different manufacturers for the production of rosuvastatin calcium, the generic version of Crestor. It appears that the FDA has decided that if they let more companies produce the generic, the price may not be as high to start …

When a patient has a sudden and continued spike in glucose levels, we often look to check their insulin levels by ordering a C-Peptide test. We know that this test measures in vivo insulin based on the measurement of C-Peptide, which is co-secreted with insulin in equimolar amounts as a consequence …